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16 Performance summary

Performance summary

This performance summary provides an overview of the work of NHS Resolution,
including the key enablers and risks to achieving our objectives and a summary of
activities we have undertaken over the past year. In particular, it sets out the activity

that meets the six priorities outlined in our Business plan for 2021/221. More detailed
information is included in the Performance analysis section (from page 29). Our
performance against key performance indicators (KPI) is covered from page 48.

Headlines

In the year 2021/22 we saw a record high in the A stark reminder that although the NEIS remains one of
proportion of 77% of claims settling without court the safest healthcare systems in the world within which
proceedings. This is evidence of our success in keeping to give birth, avoidable errors within maternity can
claims out of court by using the widest range of have devastating consequences for the child, mother
approaches to dispute resolution available to us. For and wider family, as well as the NEIS staff involved.
example, our Covid-19 Clinical Negligence Protocol,
The provision5 increased by just over half (51 %) to
launched in collaboration with claimant lawyers
£128.6 billion due largely to reductions in HM Treasury
in August 2020, continues to provide impetus to
consider alternative means of resolution and avoid long term and very long term discount rates.
2
litigation. Of the 16,484 settled1 clinical and non­ Negligence claims form a very small proportion of both

clinical claims, 48.6% settled without damages. the number of incidents and complaints reported in the
The volume of clinical negligence claims and reported NEIS, and the many millions of individual episodes of
incidents received in-year increased from 13,351 care that are delivered by the NEIS each year. There are
to 15,078, predominantly due to the continuing many factors influencing the reasons why individuals
maturity of our general practice indemnity books bring a claim against the NEIS, including factors in the
- as we received 3,292 Existing Liability Scheme legal market6. There is also a significant time lag between
for General Practice (ELSGP) and 1,502 Clinical an incident occurring and a claim being received - on
Negligence Scheme for General Practice (CNSGP) average 3.1 years. It may also take several years to settle
claims, while volumes fell marginally for the Clinical a claim, particularly those high value claims where brain
Negligence Scheme for Trusts (CNST). Alongside this, damage has occurred at birth, and payments may be
payments to claimants (damages) increased by 10.3%, made on those claims many years into the future.
while claimant legal costs increased by 5.1%.
Taken together, this means that what
Payments for settled claims in 2021/22 increased
NHS Resolution receives in terms of claims
by £199 million (8.8%) to £2.459 billion.
currently is only a very partial indicator of:
The overall cost of harm reached £13.3 billion3 in relation
• Patient safety in the NHS in past years; and also
to our CNST, with maternity claims making up 60% of
this figure - hence our continued focus on this in our • What we can expect to pay out in settlement
new three-year strategy, the importance of which was of those claims in the future.
yet further emphasised by the Ockenden Report4.

1https://resolution.nhs.uk/wp-content/uploads/2021/06/Business-plan-2021 22.pdf.
2 Settled claims include claims that have been agreed with ongoing periodical payment orders and claims where damages have been agreed or successfully
defended, and costs have yet to be agreed. This differs from closed claims, which do not include claims settled with periodical payment orders.
3 The overall cost of harm has increased from £7.9 billion last year. The HM Treasury discount rate has had a significant effect, but we estimate that
without it, the cost of harm would have increased to £8.7 billion due to the expectation of a higher volume of claims from increased NHS activity.
4 https://www.aov.uk/aovernment/publications/final-report-of-the-ockenden-review.
5 The provision is the best estimate of the expenditure required to settle the present obligation at the balance sheet date or transfer to a third party (for claims
made and predicated to be made, so called 'incurred but not reported claims'). The figure is updated annually and is an informed estimate that depends on
assumptions about future developments and therefore lies within a range of possible results. When considering the provision, it is important to note that if
there is a value allocated to a future periodical payment order this will change in response to changing needs and the lifespan of the claimant concerned.
6 See Managing the costs o f clinical negligence in trusts, NAO, September 2017.